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The course of functional decline in older people with persistently elevated depressive symptoms: longitudinal findings from the Cardiovascular Health Study.
Tuesday,2012-11-06 12:07 America/Los_Angeles — eenright
| Title | The course of functional decline in older people with persistently elevated depressive symptoms: longitudinal findings from the Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2005 |
| Authors | Lenze, EJ, Schulz, R, Martire, LM, Zdaniuk, B, Glass, T, Kop, WJ, Jackson, SA, Reynolds, CF |
| Journal | J Am Geriatr Soc |
| Volume | 53 |
| Issue | 4 |
| Pagination | 569-75 |
| Date Published | 2005 Apr |
| ISSN | 0002-8614 |
| Keywords | Activities of Daily Living, Aged, Case-Control Studies, Depressive Disorder, Disabled Persons, Female, Humans, Longitudinal Studies, Male, Multivariate Analysis, Risk, United States |
| Abstract | <p><b>OBJECTIVES: </b>To examine the relationship between persistently high depressive symptoms and long-term changes in functional disability in elderly persons.</p><p><b>DESIGN: </b>A community-based, prospective, observational study.</p><p><b>SETTING: </b>Participant data from the Cardiovascular Health Study.</p><p><b>PARTICIPANTS: </b>From the overall sample of 5,888 subjects, three types of participants were identified for this study: (1) persistently depressed individuals, who experienced an onset of depressive symptoms that persisted over 4 years (n=119); (2) temporarily depressed individuals, who experienced an onset of depressive symptoms that resolved over time (n=259); and (3) nondepressed individuals, with persistently low depressive symptoms throughout the follow-up period who were matched on baseline activity of daily living (ADL) scores, sex, and age to the previous two groups combined (n=378).</p><p><b>MEASUREMENTS: </b>Four consecutive years of data were assessed: validated measures of depression (10-item CES-D), functional disability (10-item ADL/instrumental ADL measure), physical performance, medical illness, and cognition.</p><p><b>RESULTS: </b>The persistently depressed group showed a greater linear increase in functional disability ratings than the temporarily depressed and nondepressed groups. This association between persistent depression and functional disability was robust even when controlling for baseline demographic and clinical/performance measures, including cognition. The persistently depressed group had an adjusted odds ratio (OR) of 5.27 (95% confidence interval (CI) 3.03-9.16) for increased functional disability compared with the nondepressed group over 3 years of follow-up, whereas the temporarily depressed group had an adjusted OR of 2.39 (95% CI=1.55-3.69) compared with the nondepressed group.</p><p><b>CONCLUSION: </b>Persistently elevated depressive symptoms in elderly persons are associated with a steep trajectory of worsening functional disability, generating the hypothesis that treatments for late-life depression need to be assessed on their efficacy in maintaining long-term functional status as well as remission of depressive symptoms. These results also demonstrate the need for studies to differentiate between persistent and temporary depressive symptoms when examining their relationship to disability.</p> |
| DOI | 10.1111/j.1532-5415.2005.53202.x |
| Alternate Journal | J Am Geriatr Soc |
| PubMed ID | 15817000 |
| Grant List | K05 MH 00295 / MH / NIMH NIH HHS / United States K23 MH 64196 / MH / NIMH NIH HHS / United States N01 HC 85079 / HC / NHLBI NIH HHS / United States N01 HC 85080 / HC / NHLBI NIH HHS / United States N01 HC 85081 / HC / NHLBI NIH HHS / United States N01 HC 85082 / HC / NHLBI NIH HHS / United States N01 HC 85083 / HC / NHLBI NIH HHS / United States N01 HC 85084 / HC / NHLBI NIH HHS / United States N01 HC 85085 / HC / NHLBI NIH HHS / United States N01 HC 85086 / HC / NHLBI NIH HHS / United States P30 MH 52247 / MH / NIMH NIH HHS / United States P50 HL 65111 / HL / NHLBI NIH HHS / United States P50 HL 65112 / HL / NHLBI NIH HHS / United States R01 MH 37869 / MH / NIMH NIH HHS / United States R37 MH 43832 / MH / NIMH NIH HHS / United States T32 MH 19986 / MH / NIMH NIH HHS / United States |